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Writer's pictureBMH HK

Pica

Pica - the bird who eats almost anything (intro)

  • A compulsive eating disorder where an individual persistently eats substances that are not food.

  • It originates from the Latin name of ‘Magpies’, who eats almost anything.


What is it?

  • Children and adults with pica may eat, for example, animal faeces, clay, dirt, hairballs, ice, paint, sand, metal objects and more.

  • More common in children than adults - 10-32% of children aged 1-6 are affected by pica.

  • Worldwide: 28% of pregnant women are affected by pica.

  • This odd eating behaviour can create complications such as lead poisoning or intestinal damage from ingesting sharp objects.


What are the causes?

The cause of pica is not precisely identified, but certain factors can increase the risk of developing it. Below lists three main factors out of many:

  • Cultural influences

    • Some types of pica are accepted in certain cultures. For example: In Africa, eating dirt is a common practice as they believe it helps make up for the lack of iron, calcium and other minerals in their diet. Although the intention of balancing nutrition is not particularly harmful, the microbes in the soil will cause severe sickness. The behaviour of eating dirt is called geophagia - a type of pica.

  • Negative conditions during childhood

    • Whilst many infants or children have tried to eat non-food objects as part of their learning and development, some children are not taught or are not in living conditions (poverty). This suggests that children may believe that eating non-food objects is normal. In severe cases, pica can be a coping mechanism for children to deal with abuse or neglect. It could also be attention-seeking behaviour from parents.

  • Nutritional Intake

    • Pregnant women are sometimes very cautious of their nutritional intake. Increased nutrient demand of the body may lead to nausea, vomiting and undesirable effects when deficient. A deficiency in important minerals such as iron and zinc may trigger pica, where the most common items consumed were white clay and ice. This can also be explained by the bingeing cycle.

      • Bingeing cycle: a perpetual cycle of eating and relief

        • The person tries out non-food items due to social media influence, irrational thinking or others.

        • Anxiety drops as eating it can temporarily relieve the anxious feeling.

        • ‘Positive feeling’ felt because the item consumed is appealing, and the scent/taste helped alleviate their nausea.

        • Anxiety rises as the short-lived relief fades.

        • Relief from thinking of the ‘food.’

        • Increased needs to eat to relieve nausea or undesirable feelings.


Diagnosing pica

  • The pattern of behaviour must last for at least one month.

  • A medical examination will be conducted to rule out the causes of nutrient deficiency or anaemia at the root of the unusual cravings.

  • A specialist health professional evaluates the presence of other disorders, e.g. developmental disabilities or OCD.


Treatment

  • Behavioural therapies

    • To allow the patient to acknowledge the irrational and negative consequences of eating non-food objects and associate healthy eating with positive reinforcement or reward.

    • Also addressed aspects of family and home environment to minimise recurrence.

  • Medication

    • Pills that enhance dopamine levels are sometimes enhanced when the disorder is caused by depression or mental health related issues.

    • Other drugs to supplement nutrient deficiencies are also given if needed.

Pica = ‘Crazy’ / ‘Insane’

  • Without understanding pica, many people may regard those eating ice cubes and clay as ‘crazy’ or other negatively associated and harmful words.

  • Maybe, it isn’t their choice, but it is definitely our choice to understand them better.


Sources:

Book: How psychology works DK


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